Autism

A Unique Sensory, Emotional, and Social Development

Self Stimulation and Repetition

     Autistic children’s self stimulation can be the worse problem faced by their care takers because self stimulation is too often self injurious and anti-social. So, it is a very big problem. The worse thing is the older the child, the more difficult to correct self stimulation. Self stimulation replaces external stimulation. Unlike external stimulation, self stimulation is under the total control of the child and so becomes totally embedded into the child behavior repertoire.

     When a child has a unique perception of the world that makes most external sensory stimulation uninteresting or unappealing, the child simply finds that he or she can produce his or her own sensory experiences.

     These sensory experiences replace the pleasures that would normally come from the world.

     The more self stimulatory a child becomes, the harder it is to bring him to our world.

     Most self stimulation consists of repetitive performances. If these performances are very frequent, the child desensitizes to them, increasing their intensity and frequency. The result tends to be self-injurious behaviors.

    The best way to fight self-stimulation is to begin stopping them when they start developing. Thus, the younger the child, the better it is to create a prevention plan for self stimulation. However, there is no simple way to fight the development of self stimulation. One has to work basically on all areas of sensory development to fight and prevent self stimulation.

     Self stimulation is the result of the child's lack of response to world stimuli. So, finding ways to help the child develop an interest in MANY world stimuli will help.

    This is different for every child. It takes trial and error and perseverance to help the child find external stimuli interesting. Just remember, the autistic child's nervous system is unique. What is a nice sound to you may be a terrible noise to him or her. What is beautiful to you may be cluttered or too dull to the child. You have to expose the child to many stimuli and pay attention to his or her responses.

     Even more, you must find MANY stimuli, otherwise, the child will simply obsess with the few you provide.

     Once the child has found some self-stimulating behaviors, you must take the control away from the child. If the child punches his face, take his wrist while he is doing it. Don't stop him or help him. Simply make him feel that you control it. If the child bangs his head against the wall, grab a pillow and put it between the head and the wall. If he moves, move the pillow.

     Make him feel that you control what he does. The nature of self stimulation is to have total control over your own pleasures. Taking the control away will reduce it.

     It is not enough just to take the control away because self stimulation is often a device to call attention. It does not originate as such. But after the child starts producing the self stimulation behavior, the attention to it maintains it. It is impossible to ignore behaviors such as public masturbation or self injurious behaviors. So, ignoring them is not feasible.

    There are several routes to go, depending on the behavior and what maintains it. The child’s touching himself inappropriately and masturbation should be very severely punished when the the child does this in public. A big scolding and removing the child from public fast and immediately is essential. (Please note that severe punishment does not mean corporal punishment.) A quick and severe punishment to inappropriate behavior for being in public teaches the child that those behaviors are fine in private, not in public. But DO NOT PUNISH the child or stop the child when he is doing it in private. Particularly in the case of masturbation, I face parents and teachers that want to stop the behavior altogether. Once that behavior has been learned, it is not possible to eliminate it. The best we can expect is to eliminate it from being performed in public.

    In the case of non-verbal children, self injurious behaviors may be produced to call attention or to get fed. In these cases, the child can be trained in an alternative behavior to replace the injurious behavior. I had a case in which a 19 year old non-verbal boy had a black face from punching himself and banging his face on the wall. He was a physically very well developed boy who had not developed mentally beyond 6 months of age. However, he could walk and perform physical tasks very well. Still, he was not able to learn to do anything meaningful. He had absolutely no speech. There were no words ever produced by hi,m, yet his vocal apparatus seemed to be intact. To reduce the self injurious behavior, I decided to teach him the word "bah" to ask for attention, the word "woo" to ask for water, and the word "chee" to ask for food. The first task was to simply teach him to use a word. "Bah" was the first word in the training.

    The sessions consisted of the boy’s mother, the boy, and me sitting on the floor. The mother and I had chips. Each of us took turns saying "bah" and cheering while offering a chip for saying “bah.” Each time one of us would say "bah", we would celebrate again having a chip. During this time, we would ignore the boy. He would punch himself, scream, and get close to us, looking kind of desperate. We would continue ignoring him. Every session would be the same. Every time one of us would say "bah", we would cheer and have a chip. Each session lasted over 1 hour. The boy would simply get desperate at the beginning. Eventually, he just got resigned to be ignored for one hour once we were in the session setting. We did this twice per week, for 17 weeks. Finally, at the seventeenth week, the boy said "bah." We cheered, gave him a chip, and laughed. So, he said "bah" again. We kept on celebrating, and he kept on saying "bah."

    Now, when he wanted attention, he would say "bah." Then, immediately, his mother would turn to him. When he started punching himself or banging his head, we would scold him. After he stopped for a few minutes, we would say "bah", he would say "bah," and we would cheer. His self injurious behaviors were reduced enough for his face to clear and all the bruises to disappear.

     An advantage of the reduction in frequency of the self injurious behaviors is that as they reduce, the child re-sensitizes. Therefore, the damage per instance becomes less.

     The same procedure was used for having him ask for food, using the word "chee", and for his asking for water, using the word "woo." Remember that though nineteen years old, he had only a six month’s old intelligence and so full, real words were beyond him. The second and third words took only a few sessions. The mother was a real hero, sticking to the long program regardless to the desperation of her big, strong son.

    Incidentally, teaching the boy to expect a good thing to happen when “bah” was said, was instrumental in a potentially dangerous situation. The boy was sent each day to school. One day he did not want to get off the bus when it arrived at his home. He was screaming and hurting himself and endangering the other special children on the bus. The driver, not knowing what to do was afraid to approach the strong and out of control boy. I arrived for the usual weekly session to find this situation. I got on the bus, clapped my hands happily and said in a loud, cheery voice, “Bah!” The boy stopped screaming and hurting himself and said “bah” happily back. I coaxed him off the bus saying “bah” with no problem at all. The driver learned to control him by saying "bah" too. These treatments that I have described illustrate that autism, as well as any other neurological disorder are really not illnesses. They are complex developmental unique processes that have to be treated as such.

     Each problem requires a solution that is founded on the problem itself, not on generic methods or medications.